Granuluma anulare disseminatum

A special form of Granuloma anulare is the so-called Granuloma anulare disseminatum. It is characterized by reddish to brown rough nodules, which spread over the whole body. The face is often left out.

The Granuloma anulare disseminatum occurs predominantly in adulthood and is characterized by a protracted course that can last up to 10 years. Spontaneous healing is much less frequent in this special form than in the clinical picture of an anulare granuloma with a normal course of disease. Particularly frequent are persons who have an HIV infection.

The first therapeutic approach for an anulare disseminatum granuloma is a local treatment with creams containing cortisone. Often, however, this does not lead to sufficient improvement and systemic therapy should be started. In most cases, a so-called PUVA therapy is started.

Here, a cream is first applied to the affected areas and then irradiated with UVA light. The treatment usually lasts for several months. However, creams with cortisone as the active ingredient can also help. A systemic approach is the therapy with fumaric acid esters in tablet form.

Does a granuloma also occur in Lyme disease?

Also in the case of the so-called Lyme borreliosis, which is transmitted by ticks, a skin reaction occurs as a reaction to the tick bite, which is very similar to the clinical appearance of the granuloma anulare. The first stage of Lyme disease is called erythema anulare.This means an annular redness, which usually occurs around the bite site, but is not raised. In contrast, granulomas are characterized by the formation of raised papules that protrude noticeably from the skin.

A further difference is that the papules are usually more abundant in the case of anular granuloma, whereas in the case of Lyme disease a reddened ring appears, which spreads increasingly. In rare cases, Lyme disease can also cause redness spread over the body. Then it is important to confirm or exclude Lyme disease by special examinations.